Use of the Modified Early Warning Score by Medical-Surgical Nurses to Initiate the Rapid Response Team

Miles, Iman; Anderson, Maighdlin; Ren, Dianxu; Coker, Tamara; Fennimore, Laura

doi:10.1097/ncq.0000000000000680

Cited by 1 publication

(4 citation statements)

References 13 publications

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“…2,10 Causes that can lead to failure to rescue include failure to recognize clinical changes, failure to communicate concerns, and failure of a timely response to treat the patient. 11 Missed or delayed response to clinical decline can contribute to increased length of stay, unplanned complications such as ICU admission, and increased morbidity and mortality. 10 Being on the front line of care, RNs play a crucial role in recognizing subtle changes and escalating care.…”

Section: Available Knowledgementioning

confidence: 99%

“…The MEWS generates automated notifications based on changes in real-time clinical data within the electronic health record (EHR) to illicit an urgent response. 4,10,11 Second, nurses expressed uncertainty surrounding borderline clinical changes or unrecognized sepsis criteria and often hesitated in either notifying the provider or activating the RRT. Third, variability in individual nurse practice, knowledge, and level of experience, including intuition or concern, may have contributed to a delay in RRT activation.…”

Section: Rationalementioning

confidence: 99%

“…Clinical deterioration may be preceded by hours of undetected warning signs and symptoms before a serious adverse event such as cardiopulmonary arrest 2,10 . Causes that can lead to failure to rescue include failure to recognize clinical changes, failure to communicate concerns, and failure of a timely response to treat the patient 11 . Missed or delayed response to clinical decline can contribute to increased length of stay, unplanned complications such as ICU admission, and increased morbidity and mortality 10 …”

Section: Available Knowledgementioning

confidence: 99%

“…The project hospital had not yet adopted the use of a modified early warning score (MEWS). The MEWS generates automated notifications based on changes in real-time clinical data within the electronic health record (EHR) to illicit an urgent response 4,10,11 . Second, nurses expressed uncertainty surrounding borderline clinical changes or unrecognized sepsis criteria and often hesitated in either notifying the provider or activating the RRT.…”

Section: Rationalementioning

confidence: 99%

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Using a Clinical Triggers System to Improve Early Recognition of Clinical Changes

Lee,

Leng,

Kerbel

2023

Clin Nurse Spec

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Purpose A medical-surgical telemetry unit implemented a clinical triggers system for early recognition of clinical deterioration and bedside management between nurses and providers. The goal was to decrease cardiopulmonary arrest events. Description of the Project A clinical triggers system was developed to help nurses to identify clinical markers early and advocate for prompt bedside assessment and interventions. When clinical triggers were identified, the nurse notified the provider, who performed a bedside assessment within 15 minutes. If the provider did not respond promptly, the rapid response team was activated. Outcomes Before intervention, the unit experienced 14 cardiopulmonary arrest events (rate of 1.37 per 1000 patient days). Incidences decreased annually to 5, 4, and 3 events (rates of 0.49, 0.39, and 0.3 per 1000 patient days) during the 3-year implementation period. Conclusions The clinical triggers system was successful in achieving the project objective of decreasing unit cardiopulmonary arrest events through early recognition and response to patient deterioration during the implementation period. The clinical nurse specialist helped nurses to use the clinical triggers system to detect and respond to clinical changes. Nurses were empowered to address concerns and promote patient safety.

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